Infectious Substances Shipping Document

Shipper Name/Address:
Consignee Name/Address:
Contact Telephone:
Air Waybill Number / Tracking No.:
Date of Shipment:

Details of Dangerous Goods

Proper Shipping Name Class UN Number Packing Group Quantity & Type of Packing
Additional Handling Information:
Emergency Contact:
Shipper's Declaration:
Name of Shipper:
Signature:     Date: